28 days old

Utilization Manager

Pinnacle Treatment Centers, Inc.
Georgetown, KY 40324
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  • Job Code
    112344468


Medical\/Healthcare
Georgetown, KY

Summary

This is a highly skillful position that requires an individual to work independently. This position requires knowledge
of clinical summary for all clients and excellent communications skills to process reports to behavioral health companies.

Essential Duties


  • Review with behavioral companies with updated clinical information on a timely basis.
  • Document all certification information received and advise Administration Department of any insurance
  • problems.
  • Process appeals with managed care companies.
  • Perform assessments for new admissions.
  • Participate in multidisciplinary team meetings for clinical updates.
  • Verify insurance benefits for behavioral health levels of care.
  • Review hard copy authorizations for potential problems.
  • Assist in case management duties as assigned.
  • Effectively input all authorization daily into the agency's billing software/database.


Minimum Qualifications

  • Bachelor's Degree in related field required.
  • Registered Nurse, LPN or Social Worker required.
  • Minimum 2 years experience working in substance abuse/mental health field.
  • Knowledge and background with managed care and insurance preferred.


We are an Equal Opportunity Employer with a commitment to diversity. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, national origin, age, sexual orientation, gender identity, disability or veteran status.

PI112344468

<br/><br/>Medical\/Healthcare<br>Georgetown, KY<br/><br/><b> Summary </b><br><br>This is a highly skillful position that requires an individual to work independently. This position requires knowledge<br>of clinical summary for all clients and excellent communications skills to process reports to behavioral health companies.<br><br><b> Essential Duties </b><b> <br> </b><br><br><ul><li>Review with behavioral companies with updated clinical information on a timely basis.</li><li>Document all certification information received and advise Administration Department of any insurance</li><li>problems.</li><li>Process appeals with managed care companies.</li><li>Perform assessments for new admissions.</li><li>Participate in multidisciplinary team meetings for clinical updates.</li><li>Verify insurance benefits for behavioral health levels of care.</li><li>Review hard copy authorizations for potential problems.</li><li>Assist in case management duties as assigned.</li><li>Effectively input all authorization daily into the agency's billing software/database.</li></ul><br><br><b> Minimum Qualifications </b><br><br><ul><li>Bachelor's Degree in related field required.</li><li>Registered Nurse, LPN or Social Worker required.</li><li>Minimum 2 years experience working in substance abuse/mental health field.</li><li>Knowledge and background with managed care and insurance preferred.</li></ul> <br><br>We are an Equal Opportunity Employer with a commitment to diversity. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, national origin, age, sexual orientation, gender identity, disability or veteran status.<br/><br/> <img src="https://analytics.click2apply.net/v/1w8aBafJbZOWhAprUMpop"> <p>PI112344468</p>
Posted: 2019-07-27 Expires: 2019-08-28

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Utilization Manager

Pinnacle Treatment Centers, Inc.
Georgetown, KY 40324

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